{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:37:42Z","timestamp":1786649862198,"version":"build-2736575974"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To evaluate the efficacy of liposomal amphotericin B (L-AMB) for the treatment of fungal keratitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Patients with fungal keratitis confirmed by potassium hydroxide (KOH) smear and\/or confocal microscopy were administered topical L-AMB and randomized into three groups treated with three different formulations. The medication was administered two hourly till clinical improvement was achieved, followed by six hourly till complete resolution. The outcome measures were time to clinical improvement, resolution of epithelial defect, stromal infiltrate, hypopyon, extent and density of corneal opacity, neovascularization, and best corrected visual acuity (BCVA) at 3 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Mean age of the patients was 46.6 \u00b1 14.8 years, and trauma with vegetative matter was the most common predisposing factor.\n                      <jats:italic toggle=\"yes\">Aspergillus flavus<\/jats:italic>\n                      (36%) was the most common fungus cultured, followed by\n                      <jats:italic toggle=\"yes\">Fusarium<\/jats:italic>\n                      (23%). Mean time to clinical improvement, time to resolution of epithelial defect, mean time to resolution of infiltrate, and time to resolution of hypopyon were 3.45 \u00b1 1.38, 25.35 \u00b1 8.46, 37.97 \u00b1 9.94, and 13.33 \u00b1 4.90 days, respectively, and they were comparable among the three groups. There was a significant difference between treatment failure and success cases in terms of days of presentation (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01), size of the epithelial defect (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      -value 0.04), and infiltrate size at presentation (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      -value 0.04). At 3 months follow-up, no statistically significant difference was noted in BCVA and mean scar size among groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>L-AMB in a gel form is an effective antifungal agent that promotes the healing of fungal ulcers with notably least vascularization and better tolerance.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial registration number:<\/jats:bold>\n                      CTRI\/2020\/04\/024550\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_1474_22","type":"journal-article","created":{"date-parts":[[2023,2,2]],"date-time":"2023-02-02T09:22:50Z","timestamp":1675329770000},"page":"518-523","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Evaluation of liposomal amphotericin B for the treatment of fungal keratitis in a tertiary eye care hospital"],"prefix":"10.4103","volume":"71","author":[{"given":"Vishal","family":"Kumar","sequence":"first","affiliation":[{"name":"Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pooja","family":"Kumari","sequence":"additional","affiliation":[{"name":"Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neiwete","family":"Lomi","sequence":"additional","affiliation":[{"name":"Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murugesan","family":"Vanathi","sequence":"additional","affiliation":[{"name":"Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noopur","family":"Gupta","sequence":"additional","affiliation":[{"name":"Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radhika","family":"Tandon","sequence":"additional","affiliation":[{"name":"Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Velpandian","sequence":"additional","affiliation":[{"name":"Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nishat H","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gita","family":"Satpathy","sequence":"additional","affiliation":[{"name":"Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,2,2]]},"reference":[{"key":"R1-20251006","doi-asserted-by":"crossref","first-page":"907","DOI":"10.3390\/jof7110907","article-title":"Recent perspectives in the management of fungal keratitis","volume":"7","author":"Raj","year":"2021","journal-title":"J Fungi (Basel)"},{"key":"R2-20251006","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1136\/bjo.81.11.965","article-title":"Epidemiology and aetiological diagnosis of corneal ulceration in Madurai, south India","volume":"81","author":"Srinivasan","year":"1997","journal-title":"Br J Ophthalmol"},{"key":"R3-20251006","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1111\/1469-0691.12126","article-title":"Mycotic keratitis:Epidemiology, diagnosis and management","volume":"19","author":"Thomas","year":"2013","journal-title":"Clin Microbiol Infect"},{"key":"R4-20251006","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1136\/bjo.86.11.1211","article-title":"Aetiology of suppurative corneal ulcers in Ghana and south India, and epidemiology of fungal keratitis","volume":"86","author":"Leck","year":"2002","journal-title":"Br J Ophthalmol"},{"key":"R5-20251006","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1097\/00003226-200208000-00004","article-title":"The epidemiological features and laboratory results of fungal keratitis:A 10-year review at a referral eye care center in South India","volume":"21","author":"Gopinathan","year":"2002","journal-title":"Cornea"},{"key":"R6-20251006","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1080\/09286580601001347","article-title":"Microbial keratitis in South India:Influence of risk factors, climate, and geographical variation","volume":"14","author":"Bharathi","year":"2007","journal-title":"Ophthalmic Epidemiol"},{"key":"R7-20251006","doi-asserted-by":"crossref","first-page":"297","DOI":"10.3109\/09286586.2012.690492","article-title":"Changing referral patterns of infectious corneal ulcers to a tertiary care facility in south India-7-year analysis","volume":"19","author":"Sengupta","year":"2012","journal-title":"Ophthalmic Epidemiol"},{"key":"R8-20251006","doi-asserted-by":"crossref","first-page":"273","DOI":"10.4103\/0301-4738.53051","article-title":"Review of epidemiological features, microbiological diagnosis and treatment outcome of microbial keratitis:Experience of over a decade","volume":"57","author":"Gopinathan","year":"2009","journal-title":"Indian J Ophthalmol"},{"key":"R9-20251006","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1016\/j.ophtha.2005.10.063","article-title":"Risk factors for treatment outcome in fungal keratitis","volume":"113","author":"Lalitha","year":"2006","journal-title":"Ophthalmology"},{"key":"R10-20251006","doi-asserted-by":"crossref","first-page":"e307","DOI":"10.1016\/j.jfo.2017.08.001","article-title":"Fungal keratitis","volume":"40","author":"Bourcier","year":"2017","journal-title":"J Fr Ophtalmol"},{"key":"R11-20251006","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1097\/ICO.0000000000001781","article-title":"Management algorithm for fungal keratitis:The TST (Topical, Systemic, and Targeted Therapy) protocol","volume":"38","author":"Sharma","year":"2019","journal-title":"Cornea"},{"key":"R12-20251006","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1001\/jamaophthalmol.2013.1497","article-title":"The mycotic ulcer treatment trial:A randomized trial comparing natamycin vs. voriconazole","volume":"131","author":"Prajna","year":"2013","journal-title":"JAMA Ophthalmol"},{"key":"R13-20251006","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1097\/00003226-200210000-00004","article-title":"Intracameral amphotericin B injection in the management of deep keratomycosis","volume":"21","author":"Kuriakose","year":"2002","journal-title":"Cornea"},{"key":"R14-20251006","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1097\/ICO.0b013e318030767e","article-title":"Efficacy of intracameral amphotericin B injection in the management of refractory keratomycosis and endophthalmitis","volume":"26","author":"Yilmaz","year":"2007","journal-title":"Cornea"},{"key":"R15-20251006","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.ijpharm.2007.04.028","article-title":"Liposomal amphotericin B eye drops to treat fungal keratitis:Physico-chemical and formulation stability","volume":"344","author":"Morand","year":"2007","journal-title":"Int J Pharm"},{"key":"R16-20251006","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1167\/tvst.8.3.35","article-title":"Evaluation of liposomal and conventional amphotericin B in experimental fungal keratitis rabbit model","volume":"8","author":"Rudramurthy","year":"2019","journal-title":"Transl Vis Sci Technol"},{"key":"R17-20251006","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1016\/S0002-9394(14)71701-5","article-title":"Treatment of fungal corneal ulcers with amphotericin B ointment","volume":"124","author":"Hirose","year":"1997","journal-title":"Am J Ophthalmol"},{"key":"R18-20251006","article-title":"Efficacy of topical liposomal amphotericin B for treatment of moderate fungal corneal ulcers: A randomized clinical trial comparing it with natamycin. Paper presented in World Ophthalmology Congress, Barcelona 2018, Manuscript submitted for publication","author":"Parmanand"},{"key":"R19-20251006","first-page":"537","article-title":"Grading corneal ulcers","volume":"7","author":"Harrison","year":"1975","journal-title":"Ann Ophthalmol"},{"key":"R20-20251006","doi-asserted-by":"crossref","first-page":"119","DOI":"10.22336\/rjo.2019.18","article-title":"Pearls and paradigms in Infective Keratitis","volume":"63","author":"Acharya","year":"2019","journal-title":"Rom J Ophthalmol"},{"key":"R21-20251006","doi-asserted-by":"crossref","first-page":"6395840","DOI":"10.1155\/2019\/6395840","article-title":"Fungal keratitis:Epidemiology, rapid detection, and antifungal susceptibilities of fusarium and aspergillus isolates from corneal scrapings","volume":"2019","author":"Manikandan","year":"2019","journal-title":"Biomed Res Int"},{"key":"R22-20251006","first-page":"1549","article-title":"Corneal collagen cross-linking and liposomal amphotericin B combination therapy for fungal keratitis in rabbits","volume":"9","author":"Hao","year":"2016","journal-title":"Int J Ophthalmol"},{"key":"R23-20251006","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1097\/ICO.0b013e31802b36dc","article-title":"Economic analysis of corneal ulcers in South India","volume":"26","author":"Prajna","year":"2007","journal-title":"Cornea"},{"key":"R24-20251006","doi-asserted-by":"crossref","first-page":"1787","DOI":"10.1167\/iovs.11-8478","article-title":"The clinical differentiation of bacterial and fungal keratitis:A photographic survey","volume":"53","author":"Dalmon","year":"2012","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"R25-20251006","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1001\/jamaophthalmol.2013.1612","article-title":"Differences in clinical outcomes in keratitis due to fungus and bacteria","volume":"131","author":"Prajna","year":"2013","journal-title":"JAMA Ophthalmol"},{"key":"R26-20251006","doi-asserted-by":"crossref","first-page":"114","DOI":"10.4103\/0974-620X.57310","article-title":"Epidemiological profile of fungal keratitis in urban population of West Bengal, India","volume":"2","author":"Saha","year":"2009","journal-title":"Oman J Ophthalmol"},{"key":"R27-20251006","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1038\/eye.2012.99","article-title":"Predictors of outcome in fungal keratitis","volume":"26","author":"Prajna","year":"2012","journal-title":"Eye"},{"key":"R28-20251006","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1097\/ICO.0b013e31806c791e","article-title":"Therapeutic effect of intracameral amphotericin B injection in the treatment of fungal keratitis","volume":"26","author":"Yoon","year":"2007","journal-title":"Cornea"},{"key":"R29-20251006","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1016\/j.ophtha.2011.11.034","article-title":"Voriconazole for fungal corneal ulcers","volume":"119","author":"Parchand","year":"2012","journal-title":"Ophthalmology"},{"key":"R30-20251006","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1016\/j.ophtha.2012.09.023","article-title":"Comparative evaluation of topical versus intrastromal voriconazole as an adjunct to natamycin in recalcitrant fungal keratitis","volume":"120","author":"Sharma","year":"2013","journal-title":"Ophthalmology"}],"container-title":["Indian Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijo.IJO_1474_22","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:59:14Z","timestamp":1786647554000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijo.IJO_1474_22"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2]]},"references-count":30,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/ijo.ijo_1474_22","relation":{},"ISSN":["0301-4738","1998-3689"],"issn-type":[{"value":"0301-4738","type":"print"},{"value":"1998-3689","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2]]},"assertion":[{"value":"2022-06-20","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-02","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}